Pharmacy's Opposition to Innovation

It may be strange to suggest that pharmacy is opposed to innovation, but I find more instances of opposition than signs of support. Let me further describe why I take this perspective and the reasons it is apparent in pharmacy and health care today.

First, I must define who in pharmacy is opposed to innovation. By this, I am referring to pharmacists who are employed by corporate or non-profit entities, or employers that are successfully providing services in today’s health care arena. Unless you are trying to develop or introduce an idea or product that will change the practice of pharmacy, you probably fit this description. Whether you are in a hospital, long-term care facility, or community pharmacy, you are an employee pharmacist and expect others within your organization or networking groups to provide for your employment, advocacy, professional advancement, or education.

I must also provide context for the term innovation. Incremental innovation is “a series of small improvements to an existing product or product line that usually helps maintain or improve its competitive position over time,” according to BusinessDictionary.com. This involves small tweaks to improve an existing system or further expand a current working model.

This contrasts with a term at the other end of the spectrum: disruptive innovation. This term was popularized through the work of Harvard Business School professor Clayton Christensen and is defined as “an innovation that helps create a new market and value network, and eventually disrupts an existing market and value network, displacing an earlier technology.”

As consumers, all of us are interested in seeing disruptive innovation in pharmacy and health care because the resulting activity is usually cheaper, faster, and at least maintains the same quality. But how many of us actually want disruption in our workplace and the way we practice pharmacy? Very few, if any of us, would embrace it.

Actually, we would try to fight it, citing all of the reasons it should not be allowed. We have a large investment in supporting and sustaining the system in which our employer operates. We do this by sponsoring legislation or bolstering our state pharmacy practice acts to maintain stability and protect the status quo. We argue that the new idea is bad and explain why it should not be allowed.

While we might cite “safety” or “quality” to defend the existing process, we would really be increasing the barriers to entry and trying to promote the current practice. We would also try to minimize the opportunity for disruption to occur.

I have personally seen this take place through regulations on how pharmacists consistently interact with various technologies to validate their accuracy in product preparation or selection, refusing to adopt rules that would allow technologies to help facilitate efficient care without the presence of a pharmacist, while limiting the activities of pharmacy technicians because they are not considered as competent or consistent as pharmacists.

All of these are usually championed by members within the profession to ensure all activities are safe. They are typically qualified with statements about needing to safeguard the public or preserve pharmacist jobs. For employee pharmacists, it is important that the present system is maintained because it upholds the certain functions that currently validate their paychecks. That is why I suggest we are opposed to innovation, specifically the disruptive kind.

Instead of fearing disruption, pharmacists should recognize its benefits. While it might impact our practice and change or remove some of the activities we hold dear, it is also a vehicle to expand our responsibilities and perform functions we are currently unable to do because we lack capacity. Although the fear of unemployment looms large, removing some barriers to entry can also free us to disrupt other models of care, providing services that are cheaper, faster, and of the same quality than more expensive providers.

As opposed to fearing the future by holding onto the past, I recommend that we embrace the present and try to create our future.

I would appreciate any insights and experiences you might have on this perspective. You can let me know what you think via e-mail at seckel@unc.edu.